Nasal valve treatment method and apparatus

ABSTRACT

A method and apparatus for treating a nasal valve condition including surgically forming an access path to create a pocket on a side of the patient&#39;s nose. The pocket is positioned between a soft tissue layer and opposing surfaces of upper and lower cartilages of the nose. The pocket spans a junction between the upper and lower cartilages. An implant is placed through the access path into the pocket with a length oriented to span the junction. A delivery system for placement of the implant includes a surgical tool for forming the access path and for delivering the implant into the access path.

I. BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention pertains to a treatment method and apparatus for treatinga nasal valve. More particularly, this invention pertains to a methodand apparatus for treating a nasal valve collapse.

2. Description of the Prior Art

Nasal valve dysfunction is a prevalent medical condition. Nasal valvecollapse is due to weakness of the lateral wall of the nose. At thejunction of the upper and lower nasal cartilages, this wall movesmedially during the inspiratory phase of nasal breathing.

The nasal valve acts as a restriction to nasal airflow. The nasal valvedisrupts the laminar flow characteristics of air, which would otherwiseinsulate the airflow from the mucosa of the nose. The nasal valveimparts an airflow disturbance which performs crucial nasal functions ofmixing in the air stream and enhancing the air/mucosa contacts that areessential for effective exchanges of heat, water and contaminantsbetween inspiratory air and the nasal mucosa. A description of the nasalvalve and its functions are more fully described in Cole, “The FourComponents of the Nasal Valve”, American Journal of Rhinology, Vol. 17,No. 2, pp. 107-110 (2003). See also, Cole, “Biophysics of Nasal AirFlow: A Review”, American Journal of Rhinology, Vol. 14, No. 4, pp.245-249 (2000).

While the airflow restriction of the nasal valve is an importantfunction, a weakened or otherwise compromised nasal valve can obstructthe nasal passage. Such compromise of the nasal valve can be a functionof aging. Also, such compromise can result from prior nasal surgerywhich commonly include cosmetic surgeries.

Surgery to strengthen the nasal valve has been shown to significantlyimprove quality of life. Rhee, et al., “Nasal Valve Surgery ImprovesDisease—Specific Quality of Life”, Laryngoscope, Vol. 115, pp. 437-440(2005). The most common procedure for treating nasal valve collapse isso-called alar batten grafting. In batten grafting, a patient'scartilage is harvested from any one of a number of locations such as thenasal septum or the ear. The cartilage is sculpted to an appropriatesize and shape and beveled on the edges for improved cosmetics. Thebatten graft is placed through either an external or endonasal approach.A pocket is formed overlying the cartilages of the nose with the pocketsized to receive the batten graft. Placement of the batten graft isshown in FIG. 4 (page 577) of Millman, et al., “Alar Batten Grafting forManagement of the Collapsed Nasal Valve”, Laryngoscope, Vol. 112, pp.574-579 (2002). Other nasal valve surgeries are described in Kalan, etal., “Treatment of External Nasal Valve (Alar Rim) Collapse with an AlarStrut”, Journal of Laryngology and Otology, Vol. 115, pages 788-791(2001); Karen, et al., “The Use of Percutaneous Sutures for GraftFixation in Rhinoplasty”, Archives Facial Plastic Surgery, Vol. 5, pp.193-196 (2003) and Fanous, “Collapsed Nasal-Valve Widening by CompositeGrafting to the Nasal Floor”, Journal of Otolaryngology, Vol. 25, No. 5,pp. 313-316 (1996).

The harvesting of a portion of the patient's natural cartilage is anadditional procedure and requires sculpting or other modification of thegraft prior to use. Accordingly, synthetic nasal dilators have beensuggested. An example of such is found in U.S. Pat. No. 6,106,541 toHurbis dated Aug. 22, 2000. In the ″541 patent, the nasal dilator has aV-shape with an apex placed over the bridge of the nose to support thenose in a manner similar to that of external nasal dilators such asdevices sold under the “BREATHE RIGHT” trademark by CNS Inc., 1250 ParkRoad, Chanhassen, MN 55317 and as shown in U.S. Pat. No. 5,533,449.Other types of external nasal dilators are known such as those describedin U.S. Pat. No. RE. 35,408. Other examples include U.S. Pat. No.6,322,590 to Sillers et al., dated November 27, 2001. Less invasiveprocedures include the placement of a device within the nasal cavitywithout surgically implanting the device. However, such devices can beuncomfortable and may require the patient to remove and replace thedevice on a periodic basis.

The structure of an implant for treating the nasal valve should considerthe ease by which such a device may be placed as well as cosmeticeffects following placement of the device. Devices requiring a generalanesthetic or intravenous anesthetic can only be placed in a hospitalsetting. It is desirable that a device for treating nasal valves bedesigned to accommodate placement in an office setting requiring onlyneedle injection local anesthetic.

II. SUMMARY OF THE INVENTION

According to a preferred embodiment of the present invention, the methodand apparatus are disclosed for treating a nasal valve condition. Themethod includes surgically forming an access path to create a pocket ona side of the patient's nose. The pocket is positioned between a softtissue layer (external skin or nasal mucosa) and opposing surfaces ofupper and lower cartilages of the nose. The pocket spans a junctionbetween the upper and lower cartilages. An implant is selected having alength, width and thickness sized to reside within the pocket. Thelength is sized to span the junction. The width is sized to be less thanthe width of the upper and lower cartilages. The thickness of theimplant is as thin as possible while maintaining material strength toresist bending in response to inhalation pressures at the nasal valve.The implant is placed through the access path into the pocket with thelength oriented spanning the junction. A delivery system for placementof the implant includes a surgical tool for forming the access path andfor delivering the implant into the access path.

III. BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of the front, top and left side of apatient's nose showing skeletal components and cartilages;

FIG. 2 is a bottom plan view of the components of FIG. 1;

FIG. 3 is a right side elevation view of the components of FIG. 1;

FIG. 4 is a schematic view of upper and lower cartilages (between innerand outer soft tissue layers) with the nasal valve components shown in anon-collapsed state;

FIG. 5 is the view of FIG. 4 showing the nasal valve components shown ina collapsed state;

FIG. 6 is the view of FIG. 3 showing a relative placement of a firstembodiment of an implant according to the present invention;

FIG. 7 is the view of FIG. 6 showing a relative placement of a secondembodiment of an implant according to the present invention;

FIG. 8 is a perspective view of a first embodiment of an implantaccording to the present invention;

FIG. 9 is a side elevation view of the implant of FIG. 8;

FIG. 10 is a perspective view of a second embodiment of the implantaccording to the present invention;

FIG. 11 is a side cross-sectional view of the implant of FIG. 10;

FIG. 12 is a top plan view of a delivery apparatus according to thepresent invention shown in a fully retracted state;

FIG. 13 is a side sectional view taken along line 13-13 of FIG. 12 andshowing the apparatus forming a pocket between nasal cartilage andmucosa and prior to delivery of the implant of FIGS. 10 and 11;

FIG. 14 is a top, front and left side perspective view of the deliveryapparatus of FIG. 12;

FIG. 15 is the view of FIG. 12 showing the apparatus in position fordelivery of the implant into a pocket formed between the cartilage andthe mucosa;

FIG. 16 is a view similar to FIG. 13 and taken along line 16-16 of FIG.15 showing the implant releasing from the delivery apparatus;

FIG. 17 is a perspective view of the apparatus of FIG. 15;

FIG. 18 is a view similar to that of FIGS. 12 and 15 showing a slidermechanism partially retracted for leaving an implant within a pocket;

FIG. 19 is a view similar to FIGS. 13 and 16 and taken along line 19-19of FIG. 18 showing an implant within a formed pocket and showing partialretraction of a slider mechanism;

FIG. 20 is a perspective view of the apparatus of FIG. 18;

FIG. 21 is a view showing the implant of FIGS. 10 and 11 in a pocketbetween cartilage and mucosa and with the delivery tool fully retracted;

FIG. 22 is a view showing the implant of FIGS. 8 and 9 in a pocketbetween cartilage and mucosa and with the delivery tool fully retracted;and

FIG. 23 is a bottom plan view of a nose of a patient showing incisionlocations for beginning an implantation procedure according to thepresent invention.

IV. DESCRIPTION OF THE PREFERRED EMBODIMENT

With reference now the various drawing figures in which identicalelements are numbered identically throughout, a description of thepreferred embodiment of the present invention will now be provided.

A. Anatomy

Before proceeding with a description of the apparatus and method of thepresent invention, a review of relevant anatomy will facilitate anunderstanding of the present invention. FIGS. 1-3 show in perspective,bottom plan and right side elevation, respectively, components of thenose with skeletal muscle, soft tissue (such as external skin or nasalmucosa) and blood vessels removed.

The nose N includes nasal bone NB at an upper end of the nose. Thebottom of the nose N includes the lower cartilage also referred to asthe major alar cartilage. There is both a right lower cartilage RLC anda left lower cartilage LLC, which are generally symmetrical instructure.

The lower cartilages RLC, LLC include an external component referred toas the lateral crus LC and an internal component referred to as themedial crus MC. The medial crus and septal nasal cartilage create anasal septum NS that divides the nose N into a left nostril LN and aright nostril RN.

Upper cartilages reside between the lower cartilages and the nasal bonesNB. The upper cartilages include both a right upper cartilage RUC and aleft upper cartilage LUC separated by a septal cartilage SC extendingdown the bridge of the nose N. The opposing edges of the lower cartilageLLC, RLC and upper cartilage LUC, RUC may move relative to one another.Disposed between the opposing edges is an accessory nasal cartilage(left and right) LANC, RANC.

Both inner and outer surfaces of the cartilages LLC, RLC, LUC, RUC andLANC, RANC are covered with soft tissue shown schematically in FIGS. 4and 5 as an inner mucosal tissue MT and an outer skin tissue ST. InFIGS. 4 and 5 only the left upper and lower cartilages LUC, LLC areshown with positioning relative to the septum NS.

When congested, during inhalation, airflow through the nostrils createsan inward pressure at the junction between the upper and lowercartilages. This pressure is expressed as a function of nasal resistancewhich is estimated as 10 centimeters of water per one liter per second.Cole, “The Four Components of the Nasal Valve”, American Journal ofRhinology, pages 107-110 (2003).

In response to these forces, a weakened nasal valve may collapseinwardly as illustrated in FIG. 5. In FIG. 5, it will be appreciatedthat the inward deflection is exaggerated for ease of illustration. Itwill be noted with reference to FIGS. 4 and 5 that the junction betweenthe upper and lower cartilages is a hinge point at the inwarddeflection.

B. Implant

FIGS. 8-11 illustrate examples of implants in which can be placed on thenasal cartilages for treatment according to the present invention. Theimplant of FIGS. 8 and 9 is substantially rectangular with the implant10 having dimensions including a length L, width W and thickness T. Theimplant 10 has rounded ends 11. The flat implant 10 has a smallcurvature R between the ends 11 with the first surface 10 a concave andthe second surface 10 b convex. The length L is sized to span thejunction J (FIG. 6) between the upper and lower cartilages (i.e.,greater than a spacing between LUC, LLC and RUC, RLC). The width W issized to be less than the width W* (FIG. 6) of the upper and lowercartilages such that the apparatus 10 may be placed opposing thecartilages and reside completely on one side of the nose withoutextending over the bridge of the nose N. The width W of the implant 10may be greater than the length L of the implant 10.

As will be more fully described, the implant 10 may be placed opposingthe outer surfaces of the cartilages (between the cartilages and skin)or may be placed opposing the inner surfaces of the cartilages (betweenthe cartilages and mucosa). The thickness T of the implant is selectedso that when opposing the outer surfaces of the cartilages beneath askin layer, the implant 10 does not substantially alter the externalappearance of the skin. When placed opposing the internal surfaces ofthe cartilages, the implant thickness avoids adding to an obstruction ora narrowing of the nasal passage.

By way of a non-limiting example, the length L may be six millimeters,the width W three millimeters, and the thickness T may be 0.4millimeters. The radius of curvature R is 12.5 mm. The height H is 0.74mm. The height H is the distance between the plane of the ends 11 to themaximum thickness of the implant 10. In the event, the implant 10 is notformed with a curvature R, the height H equals the thickness T.

FIGS. 9 and 10 illustrate an alternative embodiment of the implant. Theimplant 10′ is a disk having a diameter D′ of 6 millimeters. For thepurpose of interpreting the present application and the claims which areappended hereto, the disk 10′ has a length of 6 millimeters and a widthof 6 millimeters.

The disk 10′ is a hollow dome 12′ with a radius of curvature R′ of 6.0mm for a total height H′ of 0.7 millimeters. The first surface 10 a′ ofthe implant 10′ is concave and the second surface 10 b′ is convex. Thedisk 10′ includes an annular flange portion 11′ having a diameter D″ of0.5 millimeters. The wall thickness T′ is 0.4 mm.

The disk 10′ has an added advantage over the elongated implant 10 inthat orientation of the implant 10′ relative to the cartilage is notcritical. Further, the dome 12 provides an opportunity for improvedtactile feel for a surgeon identifying positioning of the implant 10′ byfeeling for the implant by palpating the soft tissue.

FIG. 6 shows placement of the implant 10 on the upper and lowercartilages RUC, RLC with the implant 10 spanning the junction J betweenthe cartilages and residing completely on the right side of the nose. Itwill be appreciated that an identical implant identically placed ispositioned on the left side of the nose overlying the left uppercartilage LUC and the left lower cartilage LLC. FIG. 7 is a similar viewto that of FIG. 6 with the implant 10′ similarly positioned spanning theupper and lower cartilages RUC, RLC.

It will be appreciated that while the implants 10, 10′ in FIGS. 6 and 7are shown on the interior surfaces of the upper and lower cartilagesRUC, RLC, the implants 10, 10′ can be placed opposing the exteriorsurfaces of the upper and lower cartilages RUC, RLC with the samerelative positioning over the junction J between the cartilages. FIGS.21 and 22 show the implants 10′, 10 placed against the internal surfacesof the cartilages LUC, LLC in a schematic representation with theimplants 10′, 10 spanning the junction J between the cartilages LUC,LLC. FIGS. 21 and 22 are not to scale and the amount of alteration ofthe contour of the mucosal tissue MT is exaggerated.

The implants 10, 10′ may be formed of any suitable material such assteel, titanium, PTFE, hydroxyl apitite or any other bio-compatiblematerial having a sufficient stiffness to resist deformation in responseto the pressures and suctions within the nostril. While the implants 10,10′ are shown smooth, they could be provided with ribs or other raisedsurfaces or surface deformations to assist the surgeon in palpating forthe implant following placement. Further, the devices 10, 10′ could beprovided with tissue in-growth surfaces either through surfacemodification or application of in-growth agents. Also, the devices couldbe drug-eluding to facilitate a healing process following implantation.

C. Delivery System

FIGS. 12-20 illustrate a delivery apparatus 20 for placing the implantin a minimally invasive procedure. Apparatus 20 includes a handle 22, aflat blade 24, and a slider mechanism 26. The apparatus 20 is preferablydisposable with the handle 22 formed of rigid plastic and, at itsproximal end, may include raised ribs 28 or other surface contours tofacilitate gripping by a surgeon.

The blade 24 is secured to the handle 22 and projects away there from ina common plane. The blade 24 includes a blade tip 30 aligned with thelongitudinal axis of the handle 22. Knife edges 30 a extend outwardlyand rearward away from the tip 30 on both sides thereof and includeedges 30 b extending substantially parallel and spaced from thelongitudinal axis X-X of the handle 22.

The blade 24 includes an opening 25 extending through the blade 24. Theopening 25 is sized to pass an implant as previously described. In theembodiment shown in the figures, the apparatus 20 is designed fordelivery of the disk implant 10′ of FIGS. 10 and 11. Accordingly, theopening 25 is circular in shape having a diameter greater than thediameter of the implant 10′. For delivery of the implant 10 of FIGS. 8and 9, the opening 22 would be provided with a length aligned with thelongitudinal axis of the handle 22 and with a length and width of theopening being greater than the length and width of the implant 10.

The slider mechanism 26 includes a body portion 34, which is receivedwithin a slot 36 formed in the handle 22. Accordingly, the slidingmechanism 26 may be urged by a surgeon to move along the longitudinalaxis of the handle 22. The body portion 34 has raised ribs 38 for easygripping by a surgeon.

A distal end of the slider 26 includes a hole 40 (FIG. 13) sized toreceive the implant 10′ and retain the implant in the hole 40 as theslider mechanism 26 is moved relative to the handle 22. The firstsurface 10 a′ of the implant 10′ opposes the handle 22. In FIGS. 12-14,the slider mechanism 26 is shown in a retracted position with the hole40 positioned proximal relative to the hole 25 and the blade 24. Theslider mechanism 34 also includes a leaf spring 44 having a proximal endsecured to the slider mechanism 26 and with a distal end 45 positionedopposing second surface 10 b′ of the implant 10′ within hole 40.

The spring 44 urges the implant 10′ towards the handle 22. Slots,aligned with the longitudinal axis of the handle 22 and blade 24, areformed in the handle 22, blade 24 and slider 26 so that the spring 44may travel to a full rest position shown in FIG. 19. FIG. 13 shows thespring 44 biased against its spring constant to a deflected position.

In the retracted positions of FIGS. 12-14, the spring 44 captures theimplant 10′ within the hole 40. When the slider mechanism 26 is movedrelative to the handle 22, the implant 10′ is urged to move with theslider mechanism 26.

FIG. 15-17 illustrate the apparatus 20 in a deployed position with theimplant 10′ positioned over the hole 25. In the deployed position, thespring 44 urges the implant 10′ through the hole 25 to a bottom surfaceof the handle.

In FIGS. 18-20, the apparatus 20 is shown in the process of beingretracted from the surgical site. A bottom side of the distal end of thespring 44 is curved to have a thickness to completely urge the implantthrough the hole 25. At the bottom surface 24 a of the blade 24, thehole 25 is angled outwardly (e.g., at 25 a) so that the surfaces of theblade act as a cam surface to ride over the implant 10′ to leave theimplant in a desired location as will be described.

D. Delivery of Implant

In order to place an implant, the surgeon uses a local anesthetic toanesthetize the incision locations of the nose. FIG. 23 illustratesincision location IL at the alar rim near the nostrils so that theincisions IL do not having a cosmetic appearance for the patient. FIG.23 shows incision locations IL on both the left and right side of thenose. It will be appreciated that a separate apparatus 20 is used fordeploying a separate implant on the left and right sides of the nose.

FIGS. 12-20 illustrate, in sequence, placement of an implant 10′ on theleft side of the nose with the implant between the cartilages LUC, LLCand an inner mucosal tissue MT. It will be appreciated the implant 10′can be similarly placed between the cartilages LUC, LLC and the outerskin tissue ST.

The surgeon grasps the apparatus 20 which is preloaded with the implant10′ and with the apparatus 20 in the fully retracted position of FIGS.12-14. The surgeon then makes the incision at the alar rim of the noseusing the blade tip 30 to form the incisions.

Using the blade 24 to form a pocket P from the incision location IL tothe junction between the upper and lower cartilages, the surgeonadvances the tool 20 toward the lower cartilage. The surgeon may guidethe tool 20 so that an incision path is formed, at the surgeon's option,against the upper surfaces of the cartilages or against the lowersurfaces of the cartilages. Since the tool 20 presents a thickness ofextremely low profile, the incision tool 20 forms an incision pathwayseparating the mucosal layer MT from the cartilages LUC, LLC.

The surgeon advances the tool so that the blade 24 forms a pocket P onthe side of the nose (again, at the surgeon's option, between the outerskin tissue ST and the cartilages or between the inner mucosal tissue MTand the cartilages). The pocket P is positioned between the soft tissuelayer (mucosal tissue ST in the example of FIG. 13) and opposing theupper and lower cartilages LUC, LLC of the nose. Further, the pocketspans a junction J between the upper and lower cartilages as illustratedin FIG. 13. FIG. 13 illustrates the fully retracted device 20 positionedwith the opening 25 spanning the junction J between the upper and lowercartilages LUC, LLC.

When the physician determines that the positioning of FIG. 13 has beenachieved, the physician then urges the slider mechanism 26 forward tothe position of FIGS. 15-17 at which point the leaf spring 44 urges theimplant 10′ through the hole 25 and with assurance that the implant 10′is positioned with its length spanning the junction J and with a firstsurface 10 a′ of the implant 10′ opposing the upper and lower cartilagesand with a second surface 10 b′ of the implant 10′ opposing the softtissue (mucosal tissue MT in FIG. 19).

The surgeon then retracts the apparatus 20 leaving the slide in thedeployed position (as shown in FIGS. 18-20). During the retraction, theangled surfaces of the blade 24 permit the blade to ride over theimplant 10′. The spring 44 continues to urge against the implant 10′ toavoid the implant 10′ moving back into the hole 25 and being retractedwith the handle.

As illustrated in FIG. 21, when the handle 22 is fully retracted, theimplant 10′ remains in the pocket P spanning the cartilages LUC, LLC andresiding between the cartilages and the mucosal tissue MT. The implant10′, by reason of its material strength, strengthens the cartilages LUC,LLC at the junction and resists excessive inward movement of thecartilages during inhalation.

Particularly on the inside of the nostrils, the mucosal tissue MT istight against the cartilages LUC, LLC. As a result, sutures or otherattachment mechanisms are not necessary since the soft tissue will holdthe implant in its desired positioning spanning the junction of thecartilages. However, if desired, the implant could be sutured or,provided with a bio-adhesive for adhering to the cartilages or the softtissue at the desired positioning. Also, if so desired, the implants canbe formed with surfaces to promote tissue in-growth to maintain theirrelative positioning in the position shown in FIGS. 21 and 22.

Having disclosed the invention in a preferred embodiment, modificationsand equivalents may occur to one of ordinary skill in the art. It isintended that such modifications and equivalents be included within thescope of the claims.

1. A method of treating a nasal valve condition of a patient's nose, themethod comprising: a) providing a tool defining a longitudinal axis thatextends from a distal tip to a proximal end, the tool having a flatcutting blade, the flat cutting blade defining a hole, the holeextending through the flat cutting blade in a direction transverse tothe longitudinal axis of the tool; b) making an entry incision in onlythe bottom edge of the patient's alar rim; c) forming a pocket thatspans a junction between upper and lower cartilages on the side of thepatient's nose by advancing the tool through the entry incision in adirection toward the cartilages and between the outer skin tissue andthe inner mucosal tissue of the nose; and d) implanting an implant inthe pocket including positioning the implant such that a length of theimplant spans the junction between the upper and lower cartilages andsuch that the implant resides completely on the side of the nose withoutextending over the bridge of the nose; e) wherein the tool carries theimplant during formation of the pocket, and wherein the implant isdeployed through the hole defined by the flat cutting blade duringimplantation.
 2. The method of claim 1, wherein the step of implantingthe implant includes implanting a first implant on a first side of thenose, the method further including implanting a second implant on asecond side of the nose, wherein the tool carries the second implantduring formation of a second pocket on the second side of the nose. 3.The method of claim 1, wherein the step of implanting the implantincludes activating the tool to deploy the implant into the pocket. 4.The method of claim 3, wherein the step of activating the tool includessliding an implant-carrying portion of the tool relative to a handle ofthe tool.
 5. The method of claim 3, wherein the step of activating thetool includes ejecting the implant into the pocket.
 6. The method ofclaim 3, wherein the step of activating the tool to deploy the implantincludes sliding a slider mechanism of the tool to a forward position atwhich a biasing element of the tool urges the implant into the pocket.7. The method of claim 6, wherein the biasing element is a leaf spring.8. The method of claim 6, further including making the entry incision inthe alar rim of the patient's nose with the flat cutting blade of thetool and advancing the tool through the entry incision, wherein thebiasing element urges the implant through the hole formed in the flatcutting blade of the tool.
 9. The method of claim 3, further includingretracting the tool from the pocket, wherein the pocket is sized suchthat the implant remains positioned within the pocket without the use ofa suture.
 10. The method of claim 3, further including retracting thetool from the pocket, wherein the pocket is sized such that the implantremains positioned within the pocket without the use of an attachmentstructure.
 11. The method of claim 1, further including making the entryincision in the alar rim of the patient's nose with the flat cuttingblade of the tool and advancing the tool through the entry incision. 12.The method of claim 1, wherein the pocket is formed between thecartilages and the outer skin tissue.
 13. The method of claim 1, whereinthe pocket is formed between the cartilages and the inner mucosaltissue.
 14. The method of claim 1, wherein the implant is deployed fromthe tool in a direction generally transverse to the direction toward thecartilages in which the tool is advanced.
 15. The method of claim 1,wherein advancing the tool includes forming an access path to thepocket, the access path being located between the outer skin tissue andthe inner mucosal tissue.
 16. The method of claim 1, wherein the implanthas a width that is less than a width of the upper and lower cartilages,and wherein the implant has a thickness that is substantially smallerthan the width of the implant and the length of the implant.
 17. Amethod of treating a nasal valve condition of a patient's nose, themethod comprising: a) making an entry incision in the bottom edge of thepatient's alar rim; b) advancing a tool having a flat cutting bladethrough the entry incision in a direction toward upper and lowercartilages, and between the cartilages and an opposing soft tissue layerof the patient's nose, to surgically form an access path and a pocket onthe side of the patient's nose, the flat cutting blade of the tooldefining a hole extending therethrough in a direction transverse to alongitudinal axis of the tool that extends from a distal tip to aproximal end, the pocket formed by the tool spanning a junction betweenthe upper and lower cartilages on the side of the nose, the toolcarrying an implant during such advancement between the cartilages andthe opposing soft tissue layer of the patient's nose; and c) implantingthe implant in the pocket between the cartilages and the opposing softtissue layer, including deploying the implant through the hole definedby the flat cutting blade of the tool in a direction generallytransverse to the direction toward the cartilages in which the tool isadvanced, wherein the implant spans the junction between the upper andlower cartilages and resides completely on the side of the nose withoutextending over the bridge of the nose.
 18. The method of claim 17,wherein the soft tissue layer is an external skin of the nose.
 19. Themethod of claim 17, wherein the soft tissue layer is an internal mucosallayer of the nose.
 20. The method of claim 17, wherein the step ofdeploying the implant includes sliding an implant-carrying portion ofthe tool relative to a handle of the tool.
 21. The method of claim 17,wherein the tool includes a biasing element that ejects the implant fromthe tool.
 22. The method of claim 21, wherein the biasing element is aleaf spring.
 23. The method of claim 21, further including making theentry incision in the alar rim of the patient's nose with the cuttingblade of the tool and advancing the tool through the entry incision,wherein the biasing element ejects the implant through the hole formedin the cutting blade of the tool.
 24. The method of claim 17, furtherincluding making the entry incision in the alar rim of the patient'snose with the cutting blade of the tool and advancing the tool throughthe entry incision.
 25. The method of claim 17, further includingretracting the tool from the pocket, wherein the pocket is sized suchthat the implant remains positioned within the pocket without the use ofan attachment structure.
 26. The method of claim 17, wherein the step ofmaking the entry incision includes making the entry incision in only thebottom edge of the patient's alar rim.